Caring for the hands
What should I do when the skin begins to heal?
Skin affected by psoriasis needs to recuperate before it is sufficiently resilient to cope with everyday aggressions. Even after it has healed, you need to take care of your hands. It can sometimes be a good idea to get someone to help with household chores.
Where can psoriasis appear on the hands?
Psoriasis can appear on the back of the hands, but it more commonly develops on the palms. Psoriasis on the hands is difficult to cope with as the lesions are more visible than those on the body or scalp and it can prevent patients from carrying out delicate tasks.
What precautions can I take for psoriasis on the hands?
It is best to avoid movements that cause repeated friction to the hands. You should try not to use your finger joints too much as this can stretch the skin, which is already weak. Extra care must be taken when psoriasis affects the joints.
Can nails be affected by psoriasis?
In 50% of cases, psoriasis on the hands affects the nails. They become white and thick, and transverse lines appear as a result of dryness.
When the cuticles are affected, they can no longer act as a protective barrier. Inflammation can also spread under the nails. Lesions under the nails heal with difficulty as they are not in contact with the air. Psoriasis can also affect the ends of the fingers, which makes it very difficult to perform delicate tasks.
How can I protect my hands and nails?
You should keep your nails as dry as possible. Every time you wash your hands, you should dry the ends of your fingers with a tissue to absorb any moisture that might otherwise penetrate under the nails. The nails should not be filed.
If the skin around the nails becomes inflamed, you should see a doctor to make sure no infection is present.
You should be very gentle when manicuring your nails, especially when dealing with the cuticle.
Any creams should be used sparingly. Lotions are often more suitable for treating lesions on the hands and nails.
What is the best way to manicure my nails?
It is tricky to look after nails weakened by psoriasis. It is best to use nail clippers rather than scissors. Pay particular attention to the edges of the nails, especially the edges of the toenails, as they can pierce the skin and spread inflammation.
Keep your nails short as long nails are more vulnerable to infection.
You can use varnish or false nails to hide the nail until it grows back normally.
You should also keep your nails very clean as the little gap at the end of the finger, between the skin and the internal surface of the nail, may harbour fungus and bacteria. Scratching can also transfer bacteria from other parts of the body to the nails. A specially formulated cream can prevent or treat nail infections.
What happens when the palm of the hand is affected?
When the palm of the hand is affected, the skin cracks very easily which allows bacteria to penetrate. A vicious circle of inflammation and infection is created. You need to be very careful when carrying out activities that cause friction to the palm of the hands. For example, knitting can aggravate lesions.
What can I do about cracks on my palms?
If your palm is cracked, you can protect the hands with gloves or bags which are sealed against air around the wrist whilst you are doing DIY, household chores and so on. The moisture which develops in the glove or bag in a few hours helps the skin to become suppler. However, gloves should not be worn permanently as the skin needs air to heal.
Do allergies and detergents play a role?
Psoriatic plaques sometimes appear on the hand after carrying out a domestic task, such as doing the dishes. At work, regular contact of the skin with chemicals can trigger a flare. This is called contact dermatosis or contact dermatitis.
Sometimes an allergic reaction, for example a nickel allergy, can provoke a flare of psoriasis on the hands. Some rubber gloves can lead to a reaction because they contain harsh chemicals.
Using harsh soaps and detergents too frequently can rid the skin of its natural oils and the skin
then becomes dry and cracks easily.
These problems often add to each other and prevent psoriasis from clearing.
Apart from using medication, how can I protect my hands?
When you are carrying out tasks where the hands could get wet, you should wear fine cotton gloves inside gloves made from a single piece of vinyl. Cotton gloves may be rinsed if detergent gets inside. You should also wear cotton gloves when dusting.
Special gloves also need to be worn for certain activities at work. You should avoid skin contact with oil, grease or any chemicals.
What gloves should be used, and how?
You should get into the habit of wearing gloves (to protect the skin), when the hands are exposed to dirt, chemicals, liquids etc. It is important to change the gloves frequently and not to wear them permanently as the skin needs air to heal. If the gloves cause perspiration, you should wear fine cotton gloves inside. Making gloves into fingerless mittens by cutting off the ends of the fingers can help you carry out delicate tasks. In the winter, you should keep your hands warm by wearing woollen or leather gloves.
- Psoriasis on the hands is not common.
- Psoriasis on the hands is hard to hide, and whether it is on the back or palm of the hands, it can make it difficult to carry out daily activities at home or work.
When the hands are affected, you should avoid exposing them repeatedly to chemicals and detergents, which can make the skin more delicate.
- Certain allergies can exacerbate the problem, in which case, you should see a specialist.
- Even with regular treatment and good hygiene, psoriasis on the hands can take months to clear. After it has cleared, good hygiene will help to prevent relapses.